The titles Registered Dietitian, Professional Dietitian and Dietitian are protected by law under both the 1991 Regulated Health Professionals Act and the Dietetics Act of Ontario.
By definition all dietitians are nutritionists given that their education, training and area of expertise is nutrition but not all nutritionists are dietitians. This is because dietitians have met national standards for education and training and are members of a regulatory body; in Ontario it’s the College of Dietitians of Ontario. Dietitians are regulated in the same way medical doctors, dentists, nurses, massage therapists, optometrists, physiotherapists etc. are.
The term nutritionist is not protected by law so people with different levels of education and knowledge can call themselves a ‘nutritionist’. Some provinces (Alberta, Quebec and Nova Scotia) have legally protected the title Nutritionist or Registered Nutritionist but in Ontario, the title ‘nutritionist’ is not regulated. Be sure to ask for clarification about education, training and clinical experience when seeking out nutritional advice and the services of a nutritional practitioner.
A dietitian is an expert in food and nutrition; they use this expertise to promote health & well-being and to reduce the risk for, and manage disease by assessing, diagnosing, and treating dietary and nutrition-related problems.
The first step is to earn a 4-year Bachelor’s degree in food science and human nutrition from an accredited university program. These programs include a range of subjects such as:
- basic sciences (chemistry, biochemistry, biology, physiology, microbiology)
- social sciences and communications
- profession-related courses, such as food science, life-cycle, disease specific/therapeutic, & community nutrition, public health, psychology, research methodology, and more
The next step is the successful completion of a 10 to 11 month supervised practical training/clinical internship in order for dietetic interns to apply the academic knowledge gained in university in practice-based settings such as hospitals, long-term care facilities, and health units (Family Health Teams or Community Health Centers).
The College (regulatory body) assesses an intern’s academic and practicum experience to determine their eligibility to write the national Canadian Dietetic Registration Examination (CDRE); once fully registered, dietitians can use the protected title Registered Dietitian (RD), Professional Dietitian (DTP in French), or Dietitian which assures the public of their qualifications and competence.
While not mandatory, most dietitians also have graduate degrees such as Master’s degrees and PhD.
Registered dietitians are health care professionals who are trained to provide advice, education and counselling about diet, food, nutrition and natural health products (nutritional supplements). They use the best available evidence coupled with clinical experience and good judgment about the client’s unique values, needs, goals and circumstances to inform their guidance and recommendations.
Dietitians use medical nutrition therapy to manage a variety of health issues such as food allergies, intolerances & sensitivities, autoimmune disorders, digestive issues, endocrine disorders (insulin resistance, diabetes, thyroid), cardiovascular disease (blood pressure, cholesterol/triglycerides), weight management, mental health issues (mood disorders like anxiety and depression), addiction recovery, liver disease, eye, dental and skin conditions.
Dietitians also focus on prevention; nutrition has a primary role in promoting and maintaining health and IN reducing the risk for chronic diseases. A dietitian can help you eat to improve your energy levels, support activity/athletics & exercise, support healthy weight gain, provide guidance on healthy eating on the run, how to navigate the food court, to be a healthy vegetarian or vegan, what to eat when you are pregnant or planning to have a baby, provide guidance on surviving the grocery store, with meal planning and recipe modification to suite your personal health goals.
Dietitians can assess your eating habits to see what nutrients you might not be getting enough of and provide advice on safe supplement use. Eating for longevity is a common reason why people seek out nutritional counselling; food choices can have a significant impact at maintaining health in the long run. Many of the health issues we all face as we age can be addressed in a way so that quality of life can be maintained into our older age but the greatest return on this health investment is to start earlier on, in our 30s and 40s.
Dietitians use food, nutritional therapy and supplements to support health goals. This can include dietary modification and specific supplements to target specific concerns and specific health goals and outcomes. Sometimes food and supplements are used to achieve a therapeutic goal, i.e. management of IBS or to reverse and prevent future bone loss while other times, diets may have to be modified to work within the parameters of a chronic condition such as with diabetes management for example. Regardless, the end goal is the same, to ensure that clients get sufficient nutrition to achieve and maintain optimal health.
During the initial visit, a dietitian will review the client’s health goals, as well as, thoroughly review his or her medical history as needed, including past and current health issues, medication and supplement use, blood work, and dietary intake. Other considerations such as psychological, social and physical variables that impact the individual, his or her food choices, and health journey will be looked at as well. Together with the client, the dietitian will work to develop a nutritional plan of action including goal setting, actionable healthy eating and lifestyle advice, and supplement use where appropriate.
During follow-up visits, the dietitian will assess the client’s progress by reviewing the goals he or she set at the initial visit to where he or she is during the follow-up appointment. The purpose of monitoring is to see what’s working, what’s not, and to address any barriers interfering with the client’s goals. The dietitian will review any new information as needed, such as test results, symptoms, food intake etc. so that any refinement of goals and strategies needed to help keep the client on track can be made.
This all depends on the nature of the visit and the health concern being addressed. Healing takes time so it may require several follow up visits after the initial consultation. Some issues such as a new celiac disease diagnosis requires an initial nutritional assessment, education on a gluten free diet and follow up visits to ensure the client is getting the support needed to follow the diet, trouble shoot challenges he or she may have while monitoring the healing progress. Several follow up visits will be needed for symptom management and to monitor the client’s nutritional status.
Some issues may need extended follow up based on ongoing blood work monitoring as in the case of diabetes, dyslipidemia (cholesterol, triglycerides) to ensure proper management is achieved to improve health outcomes.
The best care plan is part of the consultation process with the dietitian; both the RD and the client will work together to determine goals and what is needed to achieve those goals in the long run.
No. A referral is not needed. Anyone can make an appointment with a dietitian. People often reach out to dietitians on their own or on the recommendation of their doctor or other health practitioner who they’re working with.
As part of an inter-disciplinary health care team, dietitians use a client-centered approach and work with other healthcare providers/practitioners to ensure clients get the care they need to achieve their best health. When appropriate, dietitians will refer clients to other members of the team such as medical doctors, naturopathic doctors, physiotherapists, massage therapists, chiropractors etc. who will work together to ensure ‘the whole person’ is cared for.
Yes. The majority of extended healthcare insurance plans do provide coverage for treatment by Registered Dietitian and Nutritionists. Registered Dietitian services are only covered by the Ontario Health Insurance Plan (OHIP) in hospital, family health teams or community health centres.
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